Healthcare Provider Details

I. General information

NPI: 1245654680
Provider Name (Legal Business Name): JESSICA SELTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 701
WASHINGTON DC
20006-1054
US

IV. Provider business mailing address

9600 BLACKWELL RD STE 500
ROCKVILLE MD
20850-3783
US

V. Phone/Fax

Practice location:
  • Phone: 202-296-2595
  • Fax: 877-825-4709
Mailing address:
  • Phone:
  • Fax: 855-420-8517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD210011635
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: